舌侧与唇侧正畸治疗不良反应的比较。
Comparison of adverse effects between lingual and labial orthodontic treatment.
机构信息
a PhD Student, State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
出版信息
Angle Orthod. 2013 Nov;83(6):1066-73. doi: 10.2319/010113-2.1. Epub 2013 Apr 12.
OBJECTIVE
To compare adverse effects between labial and lingual orthodontic treatments through a systematic review of the literature.
MATERIALS AND METHODS
The protocol of this systematic review (CRD42012002455) was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search was conducted in PubMed, Embase, Web of Science, CENTRAL, SIGLE, ProQuest Dissertations & Theses, and ClinicalTrial.gov for articles published between January 1980 and December 2012. Primary outcomes included pain and caries; secondary outcomes were eating difficulty, speech difficulty, oral hygiene, and treatment duration. Meta-analyses were conducted in Comprehensive Meta-Analysis version 2.2.064.
RESULTS
Six studies were included, two randomized controlled trials and four clinical controlled trials; of these, four were medium quality and two were low quality in terms of the risk of bias. Five of the six outcomes were evaluated in the included studies, and treatment duration was not; pain, eating difficulty, speech difficulty were statistically pooled. Meta-analysis revealed that the pooled odds ratios were 1.20 (95% confidence interval [CI] = 0.30-4.87) for overall pain, 32.24 (95% CI = 14.13-73.55) for pain in tongue, 0.08 (95% CI = 0.04-0.18) for pain in cheek, 0.11 (95% CI = 0.03-0.42) for pain in lip, 3.59 (95% CI = 1.85-6.99) for eating difficulty, and 8.61 (95% CI = 3.55-20.89) for speech difficulty. Sensitivity analysis showed consistent results except for eating difficulty. No publication bias was detected.
CONCLUSIONS
The likelihood of overall pain was similar between the two modalities. Patients who underwent lingual orthodontic treatment were more likely to suffer from pain in the tongue and less likely to suffer from pain in the cheek and lip. Lingual orthodontic treatment increased the likelihood of speech difficulty. Eating difficulty, oral hygiene, caries, and treatment duration could not be compared in this systematic review.
目的
通过系统评价文献比较唇侧和舌侧正畸治疗的不良反应。
材料与方法
本系统评价（CRD42012002455）的方案已在国际前瞻性系统评价注册库（PROSPERO）中注册。在 PubMed、Embase、Web of Science、CENTRAL、SIGLE、ProQuest Dissertations & Theses 和 ClinicalTrials.gov 中检索了 1980 年 1 月至 2012 年 12 月期间发表的文章。主要结局指标包括疼痛和龋齿；次要结局指标包括进食困难、言语困难、口腔卫生和治疗时间。采用 Comprehensive Meta-Analysis version 2.2.064 进行 Meta 分析。
结果
纳入了 6 项研究，其中 2 项为随机对照试验，4 项为临床对照试验；其中，4 项研究在偏倚风险方面为中质量，2 项为低质量。纳入的研究评估了 5 项结局指标，而治疗时间未评估；疼痛、进食困难、言语困难进行了统计学汇总。Meta 分析显示，总的疼痛的汇总比值比为 1.20（95%置信区间[CI] 0.30-4.87），舌部疼痛为 32.24（95% CI 14.13-73.55），颊部疼痛为 0.08（95% CI 0.04-0.18），唇部疼痛为 0.11（95% CI 0.03-0.42），进食困难为 3.59（95% CI 1.85-6.99），言语困难为 8.61（95% CI 3.55-20.89）。敏感性分析结果除了进食困难外，其余结果一致。未发现发表偏倚。
结论
两种方法的总体疼痛发生率相似。接受舌侧正畸治疗的患者更有可能出现舌部疼痛，而颊部和唇部疼痛的可能性较小。舌侧正畸治疗增加了言语困难的可能性。本系统评价无法比较进食困难、口腔卫生、龋齿和治疗时间。
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